Hepatitis D virus entry inhibitor
Bulevirtide
Brand names: Hepcludex
Adult dose
Dose: 2mg SC OD (long-term)
Route: Subcutaneous
Frequency: OD
Clinical pearls
- NICE TA evaluation: chronic hepatitis D virus (HDV) infection — first targeted antiviral
- EASL HDV guidelines
- Specialist hepatology centre with HDV expertise
Contraindications
- Decompensated cirrhosis
- Hypersensitivity
Side effects
- Injection-site reactions
- Headache
- Fatigue
- Eosinophilia
- Increased bile acids
- Hepatic flare on discontinuation
Interactions
- OATP1B inhibitors
- Bile acid sequestrants
Monitoring
- HDV RNA
- HBV DNA
- ALT
- Bile acids
Reference: BNF; NICE TA evaluation; EASL HDV guidelines; SmPC; https://bnf.nice.org.uk/drugs/bulevirtide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Maddrey Discriminant Function (Alcoholic Hepatitis) · Alcoholic Liver Disease
- Lille Model (Steroid Response in Alcoholic Hepatitis) · Alcoholic Liver Disease
- FIB-4 Index · Liver Fibrosis
- Maddrey's Discriminant Function for Alcoholic Hepatitis · Hepatology
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023